Opioid Prescribing After Nonfatal Overdose and Association With Repeated Overdose
Authors: Marc R. Larochelle, Jane M. Liebschutz, Fang Zhang, Dennis Ross-Degnan, J. Frank Wharam
Journal: Annals of Internal Medicine (2016)

Letters6 September 2016Opioid Prescribing After Nonfatal Overdose and Association With Repeated OverdoseMarc R. Larochelle, MD, MPH, Jane M. Liebschutz, MD, MPH, Fang Zhang, PhD, Dennis Ross-Degnan, ScD, and J. Frank Wharam, MB, BCh, BAO, MPHMarc R. Larochelle, MD, MPHFrom Boston University School of Medicine and Boston Medical Center, and Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts.Search for more papers by this author, Jane M. Liebschutz, MD, MPHFrom Boston University School of Medicine and Boston Medical Center, and Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts.Search for more papers by this author, Fang Zhang, PhDFrom Boston University School of Medicine and Boston Medical Center, and Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts.Search for more papers by this author, Dennis Ross-Degnan, ScDFrom Boston University School of Medicine and Boston Medical Center, and Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts.Search for more papers by this author, and J. Frank Wharam, MB, BCh, BAO, MPHFrom Boston University School of Medicine and Boston Medical Center, and Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L16-0168 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:We chose to use the extended Kaplan–Meier approach to provide a descriptive summary, both graphical and numerical, of the association between the category of daily opioid dosage after an opioid overdose and risk for repeated overdose. Traditional Kaplan–Meier approaches require time-invariant covariates. Snapinn and colleagues (1) summarize well the flaws of past approaches that have chosen a single time point (that is, baseline, intermediate, or end) for time-varying covariates and compare those with their suggested extended Kaplan–Meier approach that we used. Opioid prescriptions are typically dispensed monthly and may be adjusted frequently; thus, dosages may vary greatly over ...References1. Snapinn SM, Jiang Q, Iglewicz B. Illustrating the impact of a time-varying covariate with an extended Kaplan–Meier estimator. Am Stat. 2005;59:301-7. CrossrefGoogle Scholar2. Beyersmann J, Gerds T, Schumacher M. Comment on ‘Illustrating the Impact of a Time-Varying Covariate with an Extended Kaplan–Meier Estimator' [Letter]. Am Stat. 2006;60:295-6. Google Scholar Author, Article, and Disclosure InformationAffiliations: From Boston University School of Medicine and Boston Medical Center, and Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M15-0038. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoOpioid Prescribing After Nonfatal Overdose and Association With Repeated Overdose Marc R. Larochelle , Jane M. Liebschutz , Fang Zhang , Dennis Ross-Degnan , and J. Frank Wharam Opioid Prescribing After Nonfatal Overdose and Association With Repeated Overdose Charles T. 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